The role of antibiotic prophylaxis in lichtenstein repair of primary inguinal hernia: A prospective double-blind randomized placebo-controlled trial

Abstract

Objective: The objective is to study the role of antibiotic prophylaxis, if any, in the prevention of wound infection after open mesh repair of primary inguinal hernias. Materials and Methods: Patients coming to outpatient department for open mesh repair of inguinal hernia were randomized into the placebo group and antibiotic group, a total of 150 patients were enrolled in the study. Follow-up was done up to 1 month to look for any evidence of surgical site infection using the criteria of Centers for Disease Control on wound infection. Results: Twelve patients in the antibiotic group and nine patients in the placebo group were found to have evidence of surgical site infection. This difference was found to be insignificant with P = 0.14. Three patients in the placebo group developed deep surgical site infection but on analysis, this difference was also found to be insignificant with P = 0.122.None of these patients required mesh removal. Conclusion: The result of the present study suggests that the use of prophylactic antibiotics during mesh repair of primary inguinal hernias does not give any extra protection from infections. Multicenter meta-analysis is required to give definite guidelines regarding the use of prophylactic antibiotics.

The role of prophylactic antibiotics in elective inguinal tension‐free hernia repair: A systematic review and meta‐analysis

“…A total of 1271 relevant studies were obtained in the initial search. After screening of the titles and abstracts according to the inclusion and exclusion criteria, the full text was further read, and 31 RCTs 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 were ultimately included. Among them, there were 23 studies 9 , 10 , 11 , 12 , 15 , 16 , 18 , 19 , 20 , 21 , 22 , 24 , 26 , 27 , 29 , 30 , 31 , 33 , 34 , 35 ...…”

“…Thirty‐one studies 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 were RCTs, of which 23 studies 9 , 10 , 11 , 12 , 15 , 16 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 …”

“…Seventeen studies 9 , 10 , 11 , 12 , 17 , 18 , 19 , 20 , 21 , 26 , 27 , 28 , 32 , 34 , 35 , 38 , 39 (4245 patients with inguinal hernia) reported the total incidence of surgical site infections. The total incidence of surgical site infections in the AG was 53/1937 (2.74%), and the total incidence of surgical site infections in the NAG was 93/2308 (4.1%).…”

“…The results showed that the total incidence of surgical site infections in the AG was significantly lower than that in the NAG (RR = 0.50, 95% CI [0.33, 0.75], P = 0.001). Seven studies 11 , 17 , 20 , 21 , 28 , 32 , 38 reported the total incidence of surgical site infections in the study group in the past 10 years, of which the total incidence of surgical site infections in the AG was 22/589 (3.7%), and the total incidence of surgical site infections in the NAG was 31/968 (3.2%). There was no statistical heterogeneity among the studies ( P = 0.75, I2 = 0%).…”

A randomised controlled trial of Lichtenstein repair with Desarda repair in the management of inguinal hernias

“… Injectable Amoxicillin and Clavulunic acid 1.2 g was given via intravenous route at 4 p.m. and 10 p.m. on the day of the surgery. No antibiotics oral or parenteral were given after that [ 25 ]. Early ambulation for daily routine activities was encouraged on the next day of the surgery.…”